阿托伐他汀在低龄和高龄老年患者中应用的有效性和安全性比较

目的：比较低龄老年和高龄老年患者应用阿托伐他汀的有效性和安全性。方法将88例未服用过他汀类药物的老年血脂异常患者分为低龄老年组（≥65岁，≤75岁）和高龄老年组（＞75岁，≤85岁），每晚应用阿托伐他汀10 mg，每4周复查低密度脂蛋白胆固醇（LDL-C），未达标者剂量加倍，直至每晚40 mg，分别于治疗前、治疗后4周、8周和12周测定血脂及其他生化指标。结果（1）12周时阿托伐他汀平均剂量18.5 mg，与治疗前比较，全部老年患者LDL-C水平下降36.3%（P＜0.01）。高龄老年患者LDL-C水平下降幅度略高于低龄组，分别为37.8%和34.4%。12周时LDL-C达标率总体为78.7%。高龄老年患者LDL-C达标率高于低龄老年患者，分别为82.9%和73.5%。（2）与基线比较，高龄和低龄老年患者各治疗点的谷丙转氨酶（ALT）水平呈逐渐上升趋势，但未超过正常上限的3倍。肌酸激酶（CK）水平与基线比较无明显变化。结论高龄老年患者应用阿托伐他汀LDL-C降低幅度与达标率略高于低龄老年患者，安全性基本一致，老年患者用药期间应注意监测肝酶。

Efficacy and safety of Atorvastatin in the treatment between young-elderly and old-elderly patients with dyslipidemia

ObjectiveTo explore the Young-elderly and Old-elderly patients to apply the efficacy and safety of Atorvastatin.MethodsAll the 88 hyperlipidemia participants who never used statin were divided into two groups, the young-elderly （65-75 years） and old-elderly （76-85 years）. All patients were initiated on 10 mg atorvastatin daily, and reviewed low-density lipoprotein cholesterol （LDL-C） every 4 weeks. The dose should be doubled if it was ineffective in reducing LDL-C to the target levels, but not more than 40 mg daily. During 12 weeks of treatment, blood lipids and other biochemical parameters were tested before treatment and after 4 weeks, 8 weeks,12 weeks of treatment.Results （1）Atorvastatin average dose achieving 18.5 mg at 12 weeks. Compared with that before treatment, LDL-C levels of all Old-elderly was reduced by 36.3% （P〈0.01）. LDL-C levels of Old-elderly patients was marginally higher than Young-elderly group, 37.8% and 34.4%, respectively. LDL-C levels achieved target level at week 12 for 78.7%. Compliance of Old-elderly patients was higher than Young-elderly group, 82.9% and 73.5%, respectively.（2） Compared with baseline, the growth of alanine aminotransferase （ALT） levels were comparable between the two groups, achieved the highest at 12 weeks, which is not more than 3 times the upper limit of normal. Creatine kinase （CK） levels had no significant change. Conclusions Recommended dose of Atorvastatin could effectually reduce LDL-C levels of elderly patients.The reduction and compliance of LDL-C with Atorvastatin in Old-elderly patients is higher than that in the Young-elderly patients, and the security is identical between the two groups.Elderly patients should be monitored with liver enzymes.